Module 1

Typical Dorsal Ramus:

1) Somatic Motor
2) Somatic Sensory
3) Postganglionic Sympathetics
Typical Ventral Ramus:
1) Somatic Motor
2) Somatic Sensory
3) Preganglionic Sympathetics
4) Visceral Sensory
Dorsal Root:
1) Somatic Sensory
2) Visceral Sensory
Heart:
Right atrium:
fossa ovalis
Pectinate muscles
Crista terminalis
Right AV valve with three cusps
auricle
Left atrium:
smooth muscle
Left AV valve with two cusps
Right ventricle:
Papillary muscles (A,P,S)
Moderator Band (with Anterior Pap Muscle)
Chorda Tendinae
Trabeculae Carnae
Left ventricle:
Papillary muscles (A,P)
Chorda Tendinae
Trabeculae Carnae
Ductus arteriosus > Ligamentum arteriosum
Foramen ovale > Fossa ovalis
Pulmonary arteries carry deoxygenated blood TO the lungs (pulmonary trunk of right ventricle)
Pulmonary veins carry oxygenated blood FROM the lungs to the left atrium.
Bronchial arteries carry oxygenated blood
Bronchial veins carry deoxygenated blood
Aortic and Pulmonary valves are both Semilunar valves.
Direct Branches off aorta: brachiocephalic trunk, left common carotid, left subclavian
Systole - ventricular contraction - pulmonary and aortic valves are open
Diastole - ventricular relaxation - pulmonary and aortic valves are closed - blood filling ventricles
SA node - pacemaker. action potential initiated.
SA > AV > Bundle of His.

Coronary arteries:
right:
1) right marginal a.
2) posterior interventricular a.
left:
1) Anterior interventricular a. (LAD)
2) Circumflex artery
You look GREAT from the FRONT (anterior)
Great Cardiac Vein travels with the LAD and Becomes the Coronary sinus.
Middle cardiac vein travels with the Posterior interventricular a.
Small cardiac vein travels with right marginal a.
Both middle and small dump into the coronary sinus.
Deoxygenated blood gets to the right atrium via:
1) SVC
2) IVC
3) Coronary sinus
4) Anterior cardiac veins
Pericardium from Superficial to Deep: Fibrous pericardium - Parietal pericardium - Visceral pericardium (Epicardium)
Pleural sac is empty!
No pain in lung tissue
Quiet breathing:
inspiration - contraction of diaphragm
expiration - elastic recoil of the lungs and thoracic wall
Forced/Active breathing:
Inspiration - diaphragm, scalenes, external intercostals, SCM
expiration - internal intercostals, rectus abdominis, external and internal oblique, Transverse abdominis
Sigmoid Colon receives blood from Inferior Mesenteric Artery.
Erector Spinae muscles: spinalis, longissimus, iliocostalis
Openings in the thoracic diaphragm:
C - Caval opening T8
E - Esophageal opening T10
A - Aortic opening T12
Right main bronchus - shorter, wider, in line with trachea (foreign objects)
Right lung - 3 lobes - groove for SVC, trachea, arch of azygos
Left lung - 2 lobes - arch of aorta
RALS (pulmonary artery with respect to bronchus)
Innervation of lungs:
Sympathetic - T1-T5
Bronchodilation
Reduced secretion
Constricts Pulmonary vessels
SYMP impulses:
Increase heart rate, increase stroke volume, dilate coronary arteries

Parasympathetic - Vagus
Constrict bronchi
promote secretion
dilate pulmonary vessels
PS impulses:
Slow heart rate, decrease stroke volume, constrict coronary arteries
Transverse Thoracic Plane: Sternal Angle > 4th IV disk
Separates superior mediastinum from Anterior, Middle and Posterior
Anterior Mediastinum
1) lower remnants of thymus gland
2) fat and loose connective tissue
3) lymph nodes and vessels
4) deep branches of internal thoracic arteries and veins
Middle mediastinum - PHRAM
1) Pericardial sac
2) Heart
3) Roots of great vessels (SVC, IVC, Aorta)
4) Arch of Azygos vein
5) Main Bronchi
Posterior mediastinum
1)Thoracic aorta
2) Thoracic sympathetic trunks
3) Thoracic splanchnic nerves*
4) Thoracic duct*
5) Azygos and hemiazygos veins
6) Vagus nerve*
7) Esophagus* and esophageal plexus
8) lymph nodes and vessels
* in both superior and posterior
everything else, superior!
Abdomen:
Jejunum - deep red, thick wall, more vascular, long vasa recta, few arcades.
Ileum - pale pink, thinner wall
ileocecal junction > cecum > ascending colon > right colic flexure > transverse > left colic flexure > descending >
sigmoid > rectum
Liver produces bile.
Gallbladder stores bile.
Liver: 4 quadrants - Right, Left, Caudate (next to IVC) and Quadrate (next to gall bladder)
Mesentery - double layer of peritoneum
3 unpaired arteries on abdominal aorta:
1) Celiac trunk - supplies blood to the esophagus, stomach, liver, gallbladder, spleen,
and part of duodenum and pancreas.

2) Superior mesenteric a. - supplies blood to jejunum, ileum, cecum, ascending and

transverse colon.
3) Inferior mesenteric a. - supplies blood to descending and sigmoid colon and upper
part of rectum.
Portal system - NO VALVES - 4 areas of portal/cavel overlap:
1) esophagus
2) rectum
3) paraumbilical
4) lumbar/side wall of abdomen
Sympathetic:
1) inhibits peristalsis and digestion
2) pre-ganglionics from thoracic and lumbar splanchnic
Parasympathetic:
1) increases peristalsis and digestion
2) pre-ganglionics from vagus
Intraperitoneal SALTD SPRSS
1) Stomach
2) Appendix, Cecum
3) Liver
4) Transverse colon
5) Duodenum (1st part)
6) Small intestines (jejunum, ileum)
7) Pancreas (only tip of tail)
8) Rectum
9) Sigmoid colon
10) Spleen
Retroperitoneal SADPUCKER
1) Suprarenal Glands
2) Aorta & IVC
3) Duodenum (all but first part)
4) Pancreas
5) Ureter and Bladder
6) Colon (A & D)
7) Kidney
8) Esophagus
9) Rectum (Lower)
Secondarily retroperitoneal DAMP
1) Descending colon
2) Ascending colon
3) Most of duodenum (not first part)
4) Pancreas (not tip of tail)
Vagal trunks:
anterior - left vagus nerve
posterior - right vagus nerve
Pelvis:
Fundus is part of uterus that is superior to entrance level of uterine tubes.
Blood supply to uterus is from a branch off internal iliac a.
Recto-uterine pouch is inferior most extension of peritoneal cavity.
Fornix surrounds cervix
Round ligament surrounded by two layers of broad ligament.

Deep inguinal ring - transversalis fascia

Superficial inguinal ring - External Abdominal oblique
External Abdominal Oblique m > External spermatic fascia
Internal Abdominal Oblique m > Cremaster
Transversalis Fascia > Internal spermatic fossa
Hernias:
Direct - superficial ring, medial to inferior epigastric, common in old age, from weakened muscles
Indirect - deep ring, lateral to inferior epigastric, congenital, found early in life
Innervation of pelvic diaphragm - S2,3,4 keep the asshole off the floor.
Blood supply to pelvis is mainly from internal iliac branches.
Both gonadal arteries come off the abdominal aorta
Left gonadal vein drains into left renal vein
Right gonadal vein drains into IVC

Module 2
Tongue motor and/or sensory information: CN 5, 7, 9, 12
3977 COPS - Parasympathetic innervation
3 - Oculomotor - Ciliary ganglion - Constrictor pupillae & Ciliary muscles
9 - Glossopharyngeal - Otic ganglion- Parotid Gland
7 - Facial - Pterygopalatine Ganglion - Nasal mucosa and lacrimal gland
7 - Facial - Submandibular Ganglion - Submandibular and Sublingual gland
genioglossus protrude the tongue
hyoglossus and styloglossus retract the tongue
geniohyoid - pulls hyoid anteriorly
palatoglossus - elevates back of tongue and closes oropharynx

V1 - Superior Sagital Sinus - NFL

Nasociliary
Frontal
Lacrimal
V2 - Foramen Rotundum - NIPS
Nasopalatine
Infraorbital
Palatine nerves (greater and lesser)
Superior alveolar
V3 - Foramen Ovale - BAIL
Buccal
Auricotemporal
Inferior alveolar
Lingual
Middle Meningeal Artery - Foramen Spinosum
Ansa cervicalis innervates the infrahyoid muscles.
Parasympathetic cranial nerves: 3,7,9,10
Pterion - frontal, parietal, sphenoid, temporal
Teeth: 4, 2, 4, 4-6 28-32 teeth total
Facial nerve, CN VII exit = Stylomastoid foramen.
Parotid gland innervated by glossopharyngeal - Parasympathetic

Bregma - coronal and sagittal sutures meet

Lambda - lambdoid and sagittal sutures meet
Anterior cranial fossa - frontal lobe
Middle cranial fossa - temporal lobe
Posterior cranial fossa - Occipital lobe

AEVS (another shitty mnemonic)

Arterial bleed - Epidural hematoma
Venous bleed - Subdural hematoma
Thrombosis of cavernous sinus - abducent nerve become compressed.
Granular foveolae - impressions made by arachnoid granulations
Parietal foramen - hole for emissary veins
Vessels run between periosteal and meningeal layers of dura mater.
Circle of Willis:
Anterior cerebral a. - longitudinal fissure
Middle cerebral a. - lateral fissure
Blood comes from vertebral arteries (off subclavian) and ICA off common carotid a.
AMP, SAP
Gray matter:
cortex - cingulate gyrus, parahippocampal gyrus, hippocampal gyrus, dentate gyrus
reticular formation
nuclei - amygdala, mammillary body
White matter:
association tracts
commissural tracts - Corpus Callosum, anterior and posterior commissure, Pons
projection tracts - fornix?
Opercula covers insula - parts of frontal, temporal and parietal lobes.
Transverse gyri of Heschl = primary auditory. temporal lobe
Wernickes = secondary auditory. temporal and parietal lobe. left hemisphere only.
Brocas area = secondary motor speech. frontal. left hemisphere only. lesion here = poor speech.
Wernickes REPORTS to Brocas (speaking requires language production)
Primary visual - occipital lobe
Secondary visual - Parietal lobe for locating where and Temporal lobe for identifying what it is.
Optic synapses = lateral geniculate nucleus
Auditory synapses = medial geniculate nucleus
Limbic:
cingulate gyrus, parahippocampal gyrus, hippocampal gyrus, dentate gyrus, amygdala and mammillary body
Hypothalamus - pituitary gland - vasopressin, oxytocin
Epithalamus - pineal gland - melatonin
Corpus Striatum - caudate nucleus, internal capsule, putamen
Tectum, tegmentum, cerebral peduncles, substantia nigra, red nucleus = ALL IN MESENCEPHALON
Superior colliculi - sight
Inferior colliculi - sound
Sight OVER Sound
Pyramidal tracts - motor tracts, precentral gyrus TO spinal cord. ventral side of medulla oblongata.
Olive - involuntary motor control system. ventral side of medulla oblongata.
Cuneate and Gracile - general sensory. dorsal side of medulla oblongata.
Ventricles:
1st/2nd = lateral ventricles = telencephalon = connect to 3rd via interventricular foramen.
3rd ventricle = diencephalon
cerebral aqueduct in mesencephalon

4th ventricle = rhombencephalon

sympathetic - Dilator pupillae
parasympathetic - constrictor pupillae, ciliary muscles
Horners syndrome - damage to superior cervical ganglion. drooping of upper eyelid. constricted pupil. No sympathetic innervation
to dilate the pupil. lack of sweating on face.
Superior ophthalmic vein goes through superior orbital fissure.
Ear:
outer - external auditory meatus.
middle - tympanic membrane malleus incus stapes oval window
inner - vestibular - semicircular canals and cochlear.
HUVS = horizontal movement UTRICLE. vertical movement SACCULE.
tensor tympani attaches to malleus (V3) - contracts in response to loud noises to protect tympanic membrane.
stapedius - facial nerve - prevent excess movement of stapes.
C1 - atlas, no body
C2 - axis, dens
C7 - vertebral prominens, longest spinous process
ISTHMUS IS INFERIOR TO CRICOID CARTILAGE
pretracheal fascia - organs of neck. thyroid gland, parathyroid, esophagus, trachea, pharynx, larynx
prevertebral fascia - vertebrae, longus capitis, longus coli, phrenic nerve, sympathetic trunk
carotid sheath - VAGUS, CCA, ICA, IJV
retropharyngeal space - contains nothing
NO CRANIAL NERVE HAS SYMPATHETIC FIBERS.
Nerve to mylohyoid (V3)
1) mylohyoid muscle
2) anterior belly digastric
Facial nerve
1) posterior belly digastric
2) stylohyoid
Superior root of ANSA runs with HYPOGLOSSAL N.
C1 to thyrohyoid
ansa (c1-c3) - infrahyoid muscles (except thyrohyoid)
Internal branch of Superior laryngeal n. and Superior laryngeal artery (branch of superior thyroid a.) pierce the thyrohyoid
membrane.
Right recurrent laryngeal loops under subclavian.
Left under arch of aorta
Subclavian artery - behind anterior scalene
Subclavian vein - in front of anterior scalene
inferior orbital fissure - where greater wing of sphenoid meets maxilla.
3 Jaw closers - Temporalis, Masseter, Medial Pterygoid
1 Jaw opener - Lateral Pterygoid
3 Jaw protractors - Masseter, Medial and Lateral Pterygoid
1 Jaw retracter - Temporalis

V3 inn. 4 muscles of mastication, tensor tympani, tensor veli palatini, mylohyoid and anterior belly digastric.
Great auricular nerve = cervical plexus (somatic sensory)
Auricotemporal nerve = branch of V3 Trigeminal (somatic sensory)
Posterior Auricular ARTERY = External Carotid Artery
Both upper and lower teeth blood supply come from maxillary artery. Innervation is different.
Auricotemporal nerve hugs the middle meningeal artery in infratemporal fossa.
Brachial plexus and subclavian artery = in between anterior and middle scalene.
anterior view: vagus nerve in between ICA and IJV
stylopharyngeus inn. by glossopharyngeal. goes in between superior and middle constrictor.
Torus tubarius - ridge over opening of auditory tube
Vagus = motor nerve of the pharynx. (except stylopharyngeus)
Choana - door from nasal cavity to nasopharynx
Nasal septum - primarily ethmoid, vomer .. and cartilage
Super and middle concha are part of ethmoid. Inferior concha is its own separate bone.
Below the conchas = meatus.
Superior meatus - posterior ethmoidal air cells
Middle Meatus - frontal sinus, maxillary sinus, anterior and middle ethmoidal air cells.
Inferior meatus - nasolacrimal canal
Sphenoid sinus drains into sphenoethmoidal recess.
V2 - upper lips/teeth
V3 - lower lips/teeth
vallate papillae - bumps on tongue.
palatine tonsil in between palatoglossal fold and palatopharyngeal fold
lingual tonsil - in back of tongue
tensor veli palatini hooks around hamulus on sphenoid
Tensors - V3
Palat- Vagus (except tensor veli palatini)
Glossus - Hypoglossal (except palatoglossus)
genioglossus - stick out tongue (protrude :p )
styloglossus - retract tongue
hyoglossus - retract tongue
palatoglossus - elevate back of tongue. close oropharynx
geniohyoid - pull hyoid anteriorly

Module 3
Muscles of the arm:
Upper arm:
anterior - 3
biceps brachii - supinator
coracobrachialis
brachialis - primary flexor of elbow
posterior - 1
triceps brachii - insert on olecranon process of ulna
Lower arm:
anterior
superficial - 4
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
intermediate - 1
flexor digitorum superficialis
deep - 3
flexor digitorum profundus
pronator quadratus
flexor policis longus
posterior
superficial - 6
brachioradialis - inn by radial n and is an elbow flexor
extensor carpi radialis longus
extensor carpi radialis brevis
extensor digitorum
extensor digiti minimi
extensor carpi ulnaris
anconeus
deep abductor policis longus
extensor policis brevis
extensor policis longus
extensor indicis
supinator
Hand:
Thenar (A-F-O) - Inn. by Recurrent branch of Median n.
ABductor Policis Brevis
Flexor Policis Brevis
Opponens Policis
Hypothenar (A-F-O) - Inn. by Ulnar n.
ABductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
ADductor pollicis - inn. by Ulnar n.
Name Changes:
Radial nerve:
superficial sensory branch
deep motor branch > posterior interosseous nerve after passing through supinator

(anterior interosseous nerve is a branch of median nerve)

Musculocutaneous nerve > lateral cutaneous nerve of the forearm (after passing elbow)
Radial nerve inn. brachioradialis and ECRL and then splits into deep (m) and superficial (s) nerve
External Iliac Artery > Femoral artery (after passing the inguinal ligament) which gives rise to:
1) Medial Circumflex Femoral Artery
2) Lateral Circumflex Femoral Artery (3 branches)
3) Perforating Arteries
Femoral Artery > Popliteal Artery (behind the knee)
*First gives rise to Deep Femoral Artery
Saphenous Nerve is a branch of Femoral Nerve
Anterior compartment of leg - femoral artery
Posterior compartment - deep femoral artery & perforating branches
Posterior cord of brachial plexus > Radial nerve
great saphenous vein dumps into femoral vein
small saphenous vein dumps into popliteal vein
External iliac artery > femoral artery > popliteal artery > anterior & posterior tibial arteries > anterior tibial becomes dorsalis
pedis artery
Tibial nerve ---> medial and lateral plantar nerves

Median Cubital Fossa:

Boundaries:
Biepicondylar Line
Brachioradialis
Pronator teres
Roof:
Bicipital Aponeurosis and Biceps Brachii tendon
Floor:
Brachialis and Supinator
Contents:
1) Median Nerve
2) Brachial Artery
3) Tendon of Biceps Brachii
*Median cubital vein traverses the median cubital fossa
Femoral Triangle:
Boundaries:
Inguinal Ligament
Sartorius
Adductor Longus
Floor:
Iliacus and Psoas (Iliopsoas)
Contents (Lateral to Medial)
1) Femoral Nerve
2) Femoral Artery

3) Femoral Vein
4) Lymph
Popliteal Fossa (diamond shape)
Superior Boundaries:
Medially: semimembranosus, semitendinosus
Laterally: biceps femoris
Inferior Boundaries:
Medial and lateral heads of gastrocnemius
Roof:
Fascia lata and crural fascia
Contents:
Popliteal artery and vein
tibial nerve and common fibular nerve
small saphenous vein
Coming off Anterior Superior Iliac Spine:
1) Inguinal Ligament
2) Sartorius
3) Tensor Fasciae Latae
Coming off Anterior Inferior Iliac Spine:
1) Rectus Femoris
Coming off Pes Anserinus (Gooses Foot)
1) Sartorius
2) Gracilis
3) Semitendinosus

Superficial palmar arch from Ulnar artery

Deep palmar arch from Radial artery
Adductor Magnus:
1) Ischiocondylar part - hamstring - extension at hip
2) Pubofemoral part - Adductor
*Adductor Hiatus separates the two parts

Adductor Canal (Beneath sartorius)

Femoral Artery
Femoral Vein
Saphenous Nerve
Carpal Tunnel:
Roof: Flexor Retinaculum (Hook of hamate, pisiform, trapezium tubercle, scaphoid
tubercle)
Contents:
1) Four tendons of Flexor Digitorum Superficilias
2) Four tendons of Flexor Digitorum Profundus
3) Flexor policis longus tendon
4) Median n.
Tibial - ventral rami - inn. posterior compartment of thigh.
common fibular - dorsal - inn. posterior compartment of thigh.

Abdominal Aorta
Common iliac
External iliac:
1) inferior epigastric a. (frequently pinned)
2) abberant obturator a. (sometimes)
* External Iliac > Femoral after passing the inguinal ligament.
Internal Iliac:
1) Superior gluteal a.
2) Inferior gluteal a
3) internal pudendal a.
4) uterine a. (female) / inferior vesical a. (male)
5) middle rectal a.
6) obturator a.
7) umbilical a.

Joints:
Foot:
Talocrural- dorsi/plantar flexion - talar and calcaneus
subtalar and midtarsal joint - eversion/inversion
Transverse tarsal - double joint - eversion/inversion
Fibularis - evertors
Tibialis anterior & posterior - invertors
Arch:
Ligaments - Calceneonavicular ligament, short plantar ligament, long plantar ligament,
Muscles - fibularis longus
Plantar aponeurosis - active support of the arch
Axis of foot - 2nd toe
Axis of hand - 3rd finger
Medial plantar nerve and lateral plantar nerve branch off Tibial nerve.
Medial plantar artery and lateral plantar artery branch off Posterior Tibial artery

Homologues:
Flexor digitorum profundus (in hand) = Flexor digitorum longus (in foot)
Plantar side of foot receives innervation from 5 nerves:
1) Medial plantar n. (3.5 toes)
2) Lateral plantar n. (1.5 toes)
3) Sural n. (lateral)
4) Saphenous n. (medial)
5) Tibial n. (heel)

Shoulder separation = acromioclavicular joint = coracoclavicular ligaments affected

Shoulder dislocation = glenohumeral joint = axillary nerve affected
Medial/ulnar collateral ligament - medial epicondyle to ulna - prevents adduction

Lateral/radial collateral ligament - lateral epicondyle to annular ligament - prevents abduction

Ulna is not part of the wrist joint. Only radius articulates with wrist bones. There is an articular disc on ulnar side.
Midcarpal joint enhances flexion/extension
Acetabulum - formed by ilium, ischium, and pubis.
Piriformis innervated by direct branches of sacral ventral rami.
Iliofemoral ligament - strongest ligament in the body. limits extension. keeps balance during standing.
Lateral/fibular collateral ligament - not fused with capsule. round and short.
Medial/tibial collateral ligament - fused with medial capsule and medial meniscus. flat and long.
Fibula is not involved with the knee joint.
Most injuries occur when the foot is planted on the ground.
ACL - positive anterior drawer test = sprained or torn ligament. rotation of trunk and thigh on leg with foot planted on the ground.
PCL - fall on knee. tibia is pushed backward. positive posterior drawer test = sprained or torn PCL.
Medial collateral ligament tears - blow to the lateral side of knee.
Lateral collateral ligament tears - uncommon
Unhappy triad:
1)
2)
3)

medial collateral
medial meniscus
anterior cruciate ligament

Vastus Medialis obliqus (VMO) - helps prevent lateral tracking of patella. it pulls the patella medially.
Deltoid ligament - from medial malleolus of tibia to calcaneus, talus and navicular. restricts abduction and eversion.
Rotation of the foot takes place at the transverse tarsal and subtalar joints.

*Strongest ligament in body = Iliofemoral (anterior and posterior view)

*Strongest hip flexor in body = Iliopsoas muscle
*Strongest hip abductor in body = Gluteus Medius
*Strongest inverters = Tibialis Anterior and Tibialis Posterior
*Strongest evertors = Fibularis Longus and Fibularis Brevis
*Main supinator of forearm = Biceps Brachii
*Gluteus Maximus more powerful lateral rotator than PSOIQ
triceps brachii - only elbow extensor!
Brachioradialis:
- dorsal compartment of forearm
- inn. by radial n.
- flexor at elbow joint
- does not cross wrist joint
Surgical neck fracture or Shoulder dislocation = Axillary nerve lesion
Most shoulder dislocations are anterior, with head of humerus sliding under subscapularis.
Lateral Hip Rotators: PSOIQ + Gluteus Maximus (lower part)
Piriformis

Superior gemellus
Obturator internus
Inferior gemellus
Quadrator femoris
hip ADductors
- gracilis
- adductor longus
- adductor magnus - pubofemoral
- obturator externus
Hip ABductors:
-

gluteus maximus (upper)

gluteus medius
gluteus minimis
tensor fascia latae

hamstrings
-originate on ischial tuberosity
-BI-ARTICULAR
semitendinosus and semimembranosus - medially rotate at flexed knee.
biceps femoris - laterally rotates at flexed knee

Innervation in foot:
Medial plantar n. - LAFF
Lumbrical 1
Abductor hallucis
Flexor hallicus brevis
Flexor digitorum brevis
*everything else, lateral plantar n.
*medial and lateral plantar n. coming off tibial n
Only three things in lesser sciatic foramen:
1) internal pudendal a.
2) pudendal n.
3) obturator internus m.
Gemelli, piriformis and obturator internus insert on GREATER trochanter
Sciatic nerve - L4-S3 ventral rami
Piriformis is innervated by direct branches of sacral ventral rami